BACKGROUND: Helicopters are widely used for interhospital transfers of stroke patients, but the benefit is sparsely documented. We hypothesised that helicopter transport would reduce system delay to thrombolytic treatment at the regional stroke centre. METHODS: In this prospective controlled observational study, we included patients referred to a stroke centre if their ground transport time exceeded 30 min, or they were transported by a secondarily dispatched, physician-staffed helicopter. The primary endpoint was time from telephone contact to triaging neurologist to arrival in the stroke centre. Secondary endpoints included modified Rankin Scale at 3 months, 30-day and 1-year mortality. RESULTS: A total of 330 patients were included; 265 with ground transport and 65 with helicopter, of which 87 (33%) and 22 (34%), received thrombolysis, respectively (p=0.88). Time from contact to triaging neurologist to arrival in the regional stroke centre was significantly shorter in the ground group (55 (34-85) vs 68 (40-85) min, p<0.01). The distance from scene to stroke centre was shorter in the ground group (67 (42-136) km) than in the helicopter group (83 (46-143) km) (p<0.01). We did not detect significant differences in modified Rankin Scale at 3 months, in 30-day (9.4% vs 0%; p=0.20) nor 1-year (18.8% vs 13.6%; p=0.76) mortality between ground and helicopter transport. CONCLUSIONS: We found significantly shorter time from contact to triaging neurologist to arrival in the regional stroke centre if stroke patients were transported by primarily dispatched ground ambulance compared with a secondarily dispatched helicopter.
BACKGROUND: Helicopters are widely used for interhospital transfers of strokepatients, but the benefit is sparsely documented. We hypothesised that helicopter transport would reduce system delay to thrombolytic treatment at the regional stroke centre. METHODS: In this prospective controlled observational study, we included patients referred to a stroke centre if their ground transport time exceeded 30 min, or they were transported by a secondarily dispatched, physician-staffed helicopter. The primary endpoint was time from telephone contact to triaging neurologist to arrival in the stroke centre. Secondary endpoints included modified Rankin Scale at 3 months, 30-day and 1-year mortality. RESULTS: A total of 330 patients were included; 265 with ground transport and 65 with helicopter, of which 87 (33%) and 22 (34%), received thrombolysis, respectively (p=0.88). Time from contact to triaging neurologist to arrival in the regional stroke centre was significantly shorter in the ground group (55 (34-85) vs 68 (40-85) min, p<0.01). The distance from scene to stroke centre was shorter in the ground group (67 (42-136) km) than in the helicopter group (83 (46-143) km) (p<0.01). We did not detect significant differences in modified Rankin Scale at 3 months, in 30-day (9.4% vs 0%; p=0.20) nor 1-year (18.8% vs 13.6%; p=0.76) mortality between ground and helicopter transport. CONCLUSIONS: We found significantly shorter time from contact to triaging neurologist to arrival in the regional stroke centre if strokepatients were transported by primarily dispatched ground ambulance compared with a secondarily dispatched helicopter.
Entities:
Keywords:
Critical Care Transport; Helicopter Retrieval; Neurology, Stroke; Prehospital Care, Helicopter Retrieval; Stroke
Authors: Kamilia S Funder; Lars S Rasmussen; Nicolai Lohse; Rasmus Hesselfeldt; Volkert Siersma; Jesper Gyllenborg; Sandra Wulffeld; Ole M Hendriksen; Freddy K Lippert; Jacob Steinmetz Journal: Scand J Trauma Resusc Emerg Med Date: 2017-02-23 Impact factor: 2.953
Authors: Md Golam Hasnain; John R Attia; Shahinoor Akter; Tabassum Rahman; Alix Hall; Isobel J Hubbard; Christopher R Levi; Christine L Paul Journal: Implement Sci Date: 2020-11-04 Impact factor: 7.327
Authors: Diarmuid Coughlan; Peter McMeekin; Darren Flynn; Gary A Ford; Hannah Lumley; David Burgess; Joyce Balami; Andrew Mawson; Dawn Craig; Stephen Rice; Phil White Journal: Emerg Med J Date: 2020-11-10 Impact factor: 2.740